Individual provider Active NPI

Patricia Williamson Ann Williamson

  • General Practice Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1720651623
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
2001017769 Issued in MO
Practice address
723 S Laclede Station Rd
Saint Louis, MO 63119-4911
Phone
(314) 446-2486
Fax
(314) 446-2447
NPI assigned
Jul 20, 2021
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 2001017769 MO Primary

Addresses

Primary practice location

723 S Laclede Station Rd
Saint Louis, MO 63119-4911

Mailing address

723 S Laclede Station Rd
Saint Louis, MO 63119-4911
Phone (314) 446-2486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2001017769MOMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1720651623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 S LACLEDE STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194911",
            "telephone_number": "314-446-2486",
            "fax_number": "314-446-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 S LACLEDE STATION RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194911",
            "telephone_number": "314-446-2486",
            "fax_number": "314-446-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "PATRICIA WILLIAMSON",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MO",
            "license": "2001017769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.